Billing & Insurance

Please bring your child’s insurance card with you to each and every visit.

Feel free to call: 206-783-7042


Primary care pediatricians provide a breadth of services. These services include: traditional well-child and sick-visit care and sometimes our physicians perform services that may be considered procedures or surgical services by insurance companies. Examples of these are: foreign body removal, laceration repair, wart treatment, hearing and vision screening, etc.  


We communicate to the insurance companies by telling them exactly what was performed at a visit. We do not know what your benefits are. Please become familiar with your insurance coverage so that you will know what is covered and what is not covered.

Please call our business office with any insurance related questions. We are happy to help you navigate this process.

If there is a change in your insurance coverage, please notify the clinic as soon as possible. Some insurance companies have time limits on when claims need to be submitted. If we do not have the correct information, we cannot file the claim in a timely manner.

  • Please be prepared to show your insurance card at each visit.
  • We recommend adding your newborn baby to your health plan within the first week of the baby being born to avoid claims being denied.
  • If you currently do not have insurance or insurance coverage cannot be verified, payment will be requested at the time of service.
  • If your child is being seen for a Well Child Check and you have other concerns that are not related to routine, wellness care, those concerns may generate other charges to your insurance. If your child has concerns NOT related to routine/preventative care, those may generate other charges to your insurance. At Well Child Check appointments we may perform vision, hearing or laboratory testing that may not be covered under your insurance.  In addition, there may be develpmental screening questionnaires that are not covered.  
  • It is the policy of Ballard Pediatric Clinic to collect certain information for billing purposes. Some of this information is personal and will be kept confidential.
  • If your insurance is one that we do not bill directly, please ask for a copy of the charge slip after each visit so that you can apply for reimbursement as soon as possible.
  • Copayments are due at the time of your appointment.  If you have a balance that is due we may ask for that payment.
  • It is ultimately your responsibility to know what your benefits are.
  • Please call your insurance and ask them if Ballard Pediatric Clinic is listed in your network.

We do NOT accept the following plans:

  • Community Health Plan of WA
  • Coordinated Care
  • AM Better
  • Kaiser Permanente (formerly Group Health) - We DO NOT take: Core, Sound/Choice, Alliance, Elect or Connect. The ONLY Kaiser product we take is Access PPO.
  • Tricare
  • United Healthcare Community Plan
  • Amerigroup
  • Whole Health Puget Sound (an Aetna product)

Washington Health Plan Finder

ACA-Sponsored Health Plans ONLY

Effective November 1, 2020

King County has health plans available for purchase through the Washington Health Exchange: www.wahealthplanfinder.org.

The products that we are contracted to take through the EXCHANGE is:

Molina Marketplace (Non-Apple Health Plan)

Lifewise Primary

Premera Heritage Signature